Guide to Rehab
A Complete Beginner’s Guide To Going To Rehab
Addiction is always a frightening thing to confront. When you’re in the midst of it, there seems no way out. If it’s a loved one afflicted with the disease, you fear that they might not make it. No matter where you’re standing, the specter of addiction is daunting, and often mystifying. But rehab doesn’t have to be.
Rehab is never an easy choice. Often, people only choose to enter rehab when they feel they have no other options. However, the more you know about rehab, the more you’ll see it as an attractive, liberating journey. It takes courage and determination, but it is also a peaceful, rewarding experience that can actually be quite enjoyable.
In order to demystify rehab, this guide will take you through the entire process, from choosing to go to rehab or staging an intervention, to what happens once a person leaves in- or outpatient treatment. Use this guide if you are considering going to rehab, or if you have a loved one for whom you think rehab might be the best option.
The process will be unique to every individual, but the stages are universal.
Unless it is court-mandated, you or your loved one has to choose to enter rehab. There are two common precursors to this happening:
- you or your loved one is able to recognize that rehab is necessary
- you or your loved ones stage an intervention to show their concern and encourage going to rehab
In some cases, it can be easy to recognize that you need to enter rehab. You may have lost your job. Your relationships are falling apart. You go through withdrawals if you do not use your substance of choice for a period of time. You increasingly feel you need it in order to function.
While the choice to enter rehab comes with certain sacrifices and obstacles, you realize that continued addiction will only lead to bigger problems down the line. You understand that beating the addiction on your own might be too big an ask and that you need help.
Staging an intervention
Sometimes, a loved one does not recognize the damage that they are causing. They are hurting themselves and those who care for them, but cannot see it because they are not thinking clearly. Alternatively, they understand that they need help, but are concerned about practical challenges and the sacrifices they will need to make.
In this case, you can choose to stage an intervention. If the thought of an intervention is overwhelming, you don’t have to (and shouldn’t) do it alone. Enlist the help of an intervention specialist, who will walk you through the process and design it so as to elicit the best possible results. They will be there with you, and will facilitate the process so that it does not devolve into an argument or unhealthy conversation.
Keep in mind that an addict has very real reasons for not wanting to enter rehab. These might include concerns about:
- Job security: their fear of losing a job should not be disregarded. Ultimately, addiction will do far more damage to their job security than rehab, but it is difficult for an addict to see it that way
- Missing out: this is especially true for people with a spouse and/or children. Again, addiction can only harm a family, but it is still painful to leave them for an extended time
- Stigma: unfortunately, parts of society still see addiction as something shameful. Admitting that you have a problem requires you to swallow your pride – don’t expect it to be easy on your loved one
Once you or your loved one has decided to enter rehab, the process takes the following stages:
- Detox (for some)
- Inpatient treatment
- Adapting to life on your own
Not everyone needs to detox before entering rehab, but for many, this is a step that cannot be skipped.
Who needs to detox?
You will need to detox if your body has become dependent on a substance. When you stop using the substance, your body can go into shock or experience severe withdrawal symptoms that can be dangerous. This will be true for anyone addicted to alcohol, and all other substances other than cocaine, crystal methamphetamine (meth) and marijuana.
However, even if you are addicted to cocaine, meth, or marijuana, you may still need a detox period, to get used to the feelings (both physical and emotional) of not using the substance.
Detox may be recommended if you are not physically dependent on the substance, so that you can enter rehab with as clear a state of mind as possible.
How long will detox take?
This will depend on the substance to which you are addicted. Every detox experience is unique. Withdrawal symptoms can last from hours, to days, to several weeks. It depends on a range of factors, including the substance, how it is ingested, the length of the addiction, co-existing mental and physical health conditions, and more.
Why does this have to come BEFORE rehab?
If you’re worried about spending too much time in both detox and rehab, and your substance of choice does not have major withdrawals, you might wonder why you can’t start the rehab program while detoxing. The simple answer is that you’re unlikely to succeed at the program if you don’t have a sober mind. While the substance is still clouding your thinking, you’re unlikely to make major progress. Adjusting your perspective is difficult enough without the substance still having its effect.
Once you’ve detoxed, you are ready to start the inpatient treatment program at your rehab. Inpatient treatment is highly recommended for long-term addiction. The more severe the addiction, the more need there is for a program in an environment in which it is impossible to relapse. Since all meals are prepared onsite, and the lifestyle is regulated, you will be physically healthy while you focus on your treatment.
This is what you can expect from treatment in a rehab institution.
Environment and community
You might expect rehab to be a dour place, filled with unhappy people at odds with doctors, nurses, and counselors. However, you will be pleasantly surprised.
In reality, rehabs are nurturing environments and the patients know it. The environment is peaceful, comfortable, and often lighthearted. Yes, everyone there is battling addiction, and that’s no laughing matter. There will be plenty of moments in which you’re struggling to manage difficult emotions. But outside of groups and therapy sessions, you’ll get much-needed downtime.
Since you’re with a group of people in the same boat as you, it’s easy to make friends. You’ll have lots to joke about, whether you’re sharing stories from outside rehab, or airing your gripes about something that happened in rehab.
You’ll also be sharing some of your most personal feelings and thoughts, and you’ll get to connect with other patients on a level that is rare outside of rehab. Being in a group of peers, all striving towards a common goal, will not only help you succeed, but will make your rehab experience rewarding, enjoyable, and something to cherish.
As you are no doubt aware, the 12-Steps are the gold standard for recovery from addiction. Originally developed by the founders of Alcoholics Anonymous, 12-Step programs have been adapted to combat addiction of all types. In rehab, you will likely follow a 12-Step program.
The 12-Step model considers addiction a disease. There is no surefire cure for addiction (and indeed the 12-Steps do not promise a cure), but the 12-Step model is believed to be more successful than any other model. Due to the need for anonymity, along with the long-term nature of addiction, researchers have found it difficult to conduct studies on its efficacy.
However, there is an ever-growing community of 12-Step “alumni” who will attest that the 12 steps work.
The first step is to admit powerlessness over your addiction – that your life has become unmanageable. To read through the rest of the steps and find out more about 12-Step programs, 12Step.org provides extensive information.
Although the 12-Steps are highly spiritual, they do not dictate religious beliefs. People of all faiths, agnostics, and atheists can all find meaning in them.
Non 12-Step Rehab
For some patients, the 12-Step program will not be effective. This may be because the steps do not resonate, the patient cannot find meaning in the spirituality, or many other reasons. In this case, a non 12-Step rehab may be recommended.
Non 12-Step programs do not conceptualize addiction as a disease, and take a far more secular view. The 12-Steps will usually be the first port of call, but for many who did not benefit from them, non 12-Step programs have been effective.
These programs combine a number of methods to provide a holistic approach to recovery. Methods include psychotherapy, holistic techniques, evidence-based treatment models and in some cases group therapy.
How long is a rehab program?
There is no definitive answer to this question, as it depends on a number of factors, including the needs of the patient, the approach of the rehab, and, for many, the cost of the program. Most rehab programs last 28 days, 60 days, or 90 days. Some people need long term treatment, and will remain in a rehab for many months.
Who needs long term rehab?
There are some people who need more than 90 days of rehab. This could be due to a number of factors. They may have relapsed after previous short term rehab stays. They may have been diagnosed with a co-occurring mental illness. Some simply need more help adapting to outside life while living in a rehab facility and participating in its programs.
There is no set answer to this question, and each person will be assessed on a case-by-case basis.
At the end of rehab, you do not simply exit the program. Rather, preparations are made for your discharge. You and the rehab staff will devise measures to help you stay clean while adjusting to the outside world. You will discuss practical considerations, as well as preemptive plans for what to do if you feel close to (or do) relapse.
Rehab staff have seen many patients exit at the end of the program. Some have succeeded, others have relapsed and returned for further treatment. They have a wide knowledge of why people relapse, and will prepare you for foreseeable scenarios. They will put measures into place, including providing you extensive information on their aftercare or outpatient program.
Every patient needs a plan for what they’re going to do after they leave rehab. Without one, they are far more likely to relapse. Having a healthy living arrangement and being gainfully employed are of major importance.
There may be certain triggers in your old living environment that vastly increase your chances of relapse. This is especially true if you have been living with someone who is still using. New living arrangements are often necessary.
Employment is also important, even if you do not need the money. This is because it boosts self-esteem, keeps you busy at times you would normally crave substances, and helps build independence you may have lost while using.
These are factors that will be discussed in detail before you are discharged from rehab, to give you the best chance of preventing relapse.
Aftercare, or outpatient recovery, is an important part of the rehab process. A stay in rehab does not “cure” addiction. Inpatient treatment occurs in isolation, and outpatient treatment provides the necessary support while you adapt to clean living in the outside world.
Aftercare treatment will be negotiated with the patient prior to discharge, and is generally unique to each individual.
Rehabs that follow the 12-Step model will ask you to attend regular meetings, and get involved in NA or AA “service”. Participating in the running of your local meeting provides more meaning to the process and can give you the impetus to stay clean.
Sober living facilities
Sober living facilities provide a transition between rehab and home, which some find very helpful. These facilities are intended as a clean environment, and regularly conduct drug tests on their residents. Each has its own rules. Some require you to find employment and participation in a specific outpatient program.
Therapy is a part of the aftercare program, especially if it was effective during inpatient treatment. Your therapist will know your triggers and be able to guide you through difficult scenarios.
Some people will opt for a sober coach – someone who is with them 24/7, to ensure they do not relapse.
Adapting to independent living
The aftercare or outpatient program is intended as a transitional period, and ideally ends when you have adapted to independent living. While you are now “on your own”, the rehab, your therapist, and meetings and support groups, are still all available to help you stay on track. Independence is important, but does not preclude getting help. Addiction needs to be managed, and strength can be found in the support of others.
Nothing can completely prepare you for the rehab experience, and in many ways this is a good thing. While the prospect of rehab can be daunting, it usually turns out to be a period of time that you’ll cherish for the rest of your life. You’ll learn a lot about yourself, as well as make connections that are unparalleled in the outside world. It is the beginning of a rewarding journey that will continue benefiting you for the rest of your life.